Member Financial Specialist

Role Overview

• Work 1:1 with members prior to member registration and during ongoing treatment to address questions on eligibility, benefits, payment, and more
• Educate members about benefits, member responsibility, payment options and financial assistance
• Complete ongoing eligibility checks, prior authorizations, and solve complex insurance issues on behalf of our members, working directly with the payer where needed
• Communicate with our members over video and insurance companies on the phone where necessary
• Review and process prior authorization and other forms

Requirements

• Bachelor’s degree preferred
• At least two years of experience with direct member-facing experience in patient access, financial counseling, and/or utilization management; SUD/Behavioral Health setting strongly preferred
• Experience speaking with SUD/Behavioral Health patients to interpret their coverage, benefits, patient responsibility, and more
• Experience working with members via telehealth
• Experience with state Medicaid portals, (Availity and Zendesk preferred)
• Experience speaking directly with payers and navigating payer organizations to solve problems
• Experience and working knowledge of commercial, Medicare, and Medicaid plans with behavioral health/SUD coverage and benefits
• Experience creating and explaining payment plans to SUD/Behavioral Health members
• Skill in responding quickly to member needs
• Skill in quickly learning about new insurance plans
• Skill in operating effectively in a remote environment
• Skill in operating electronic medical records (eClinicalWorks experience preferred)
• Skill in operating other needed technology
• including video-conferencing, ticketing systems, and more
• Experience in a high-growth environment strongly preferred
• Deeply invested in patient success

Benefits

• Health insurance
• Flexible work arrangements
• Professional development